United States Health Information Knowledgebase

 

Other Coverage Code

Name:Other Coverage Code
Field:308-C8
Definition:Code indicating whether or not the patient has other insurance coverage.
Type:Data Element
$attribute_name$:$attribute_value$
Version:04-2014
Registration Authority:National Council for Prescription Drug Programs
Source:National Council for Prescription Drug Programs
Values for: Other Coverage Code
Value Value Meaning
0 Not Specified by patient
1 No other coverage - Code used in coordination of benefits transactions to convey that no other coverage is available.
2 Other coverage exists-payment collected - Code used in coordination of benefits transactions to convey that other coverage is available, the payer has been billed and payment received.
3 Other Coverage Billed - claim not covered - Code used in coordination of benefits transactions to convey that other coverage is available, the payer has been billed and payment denied because the service is not covered.
4 Other coverage exists-payment not collected - Code used in coordination of benefits transactions to convey that other coverage is available, the payer has been billed and payment has not been received.
8 Claim is billing for patient financial responsibility only - Copay is a form of cost sharing that holds the patient responsible for a fixed dollar amount for each product/service received and regardless of the patient's current benefit status, product selection or network selection.
 
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